1. Learning Goals
To understand the magnitude of drug information available today
To understand the differences between primary, secondary, and tertiary resources
To be able to classify questions as background or foreground

2. There are three categories (types) of drug information resources based upon their proximity to the original source of information:

3. Resource Types:
Primary
Secondary
Tertiary

4. Primary Resources Scientific journals
Provide original studies or reports
E.g. Clinical trial, case series, case report
Good for foreground questions
Scope is narrow
Good when topic is new or new data has been published

5. PRIMARY RESOURCES
This type of resource is considered to be the most current source of information and forms the basis for the practice of evidence-based medicine
evidence-based medicine, which is defined as the conscientious, explicit, and judicious use of current best evidence along with clinical expertise and patients’ values in making clinical decisions about the care of individual patients

6. Primary Resources Pros: Cons: Most current evidence
Provide data on new drugs
Can personally assess validity of studies
Cons:
May not lead one to best decision because of limited scope
Data can be poor or controversial
Every study has limitations
Too complex for patients

7. Secondary Resources
Bibliographic databases that provide abstracts or full-text of studies
Good for foreground questions

8. SECONDARY RESOURCES
Secondary resources serve as gateways to primary drug information resources
These include indexing services, which provide bibliographic citation information, and abstracting services, which—along with the bibliographic citation information—provide a brief synopsis of each article.
Most of these services are available in an electronic format

9. Tertiary Resources Compilations of knowledge in the field
E.g. Textbooks, handbooks, online drug compendia
Good for background questions
Scope is broad

10. TERTIARY RESOURCES summarize and interpret the primary literature
the most common types of references pharmacist will utilize.
good starting point when researching a drug information question
excellent sources for gaining an understanding of a new topic.
include textbooks, review articles, and other general data.

11. Tertiary resources disadvantages
time associated with publication, which may be as long as one to two years . or some of the information may be outdated, particularly if new guidelines or new material has been released since the time of publication of the reference
the information provided may be incomplete due to space limitations or because of incomplete literature searches performed by the author(s) of the material.

12. consider when utilizing these resources are the expertise of the author, purpose of the book, edition and year of publication, references cited, ease of use, and format in which the information is being obtained.

13. Tertiary, Secondary, Primary
When trying to answer a clinical question, the best strategy is often to consult resources in the following order:
Tertiary, Secondary, Primary
Tertiary resources are good when:
The answer to a question is basic factual knowledge in the field
The question was studied extensively and a conclusion was made
Many experts have addressed the question and agree on answer
Secondary and primary resources are good when:
A question is new and has never been studied
There is no consensus among experts; various opinions abound
There is conflicting evidence and the question needs further study

14. Resource Table Primary Resources Secondary Tertiary
JAPhA JAMA Pharmacotherapy
New England Journal of Medicine
Annals of Internal Medicine AJHP
Secondary
PubMed/Ovid MEDLINE
Cochrane Database of Systematic Reviews
Tertiary
Drug Facts and Comparisons
Epocrates Lexi-Comp Micromedex
Clinical Pharmacology

15. Background v. Foreground Questions

16. Background Questions Question is broad in scope
Answer is general knowledge in field
Can best be addressed with tertiary resources
E.g. Is a drug available in the U.S.?
What is a drug’s mechanism of action?
When is a drug contraindicated?

17. Foreground Questions Question is narrow in scope
Answer may require examining new or conflicting evidence
Can best be addressed with secondary and primary resources
E.g. How effective is a new drug when compared to
drugs that are already on the market?
Are there clinical trials supporting an off-label use of a
drug in a specific population?

18. Lab session Use internet to locate
One primary reference
One secondary reference
One tertiary reference
Write title and brief description of each one on your logbook.